| 葛乔波,余建平,盛吉芳.和络舒肝片联合替诺福韦在肝硬化患者中的应用疗效研究[J].浙江中西医结合杂志,2023,33(10): |
| 和络舒肝片联合替诺福韦在肝硬化患者中的应用疗效研究 |
| Application of Tenofovir combined with Luoshugan tablet in patients with cirrhosis |
| 投稿时间：2022-12-25 修订日期：2023-04-17 |
| DOI： |
| 中文关键词: 肝硬化 和络舒肝片 替诺福韦 脾静脉血流动力学 肝纤维化 |
| 英文关键词:Liver cirrhosis Heluoshugan tablets Tenofovir Splenic vein hemodynamics Liver fibrosis |
| 基金项目:国家自然科学基金 常规面上项目(81670567)。 |
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| 中文摘要: |
| 目的 探讨肝硬化患者治疗选用和络舒肝片联合替诺福韦方案临床疗效及在脾静脉血流动力学改善方面发挥的作用。方法 选取2019年10月至2022年10月在浙江大学医学院附属第二医院临平院区收治并符合本次研究条件的100例肝硬化患者作为研究对象,按照信封法随机分为对照组、研究组各50例。对照组患者为单独使用替诺福韦25mg/次,1次/日；研究组为替诺福韦基础上加用和络舒肝5片/次,3次/d。观察治疗6个月后患者脾静脉血流动力学指标、肝纤维化指标及中医症候积分变化及门静脉内径、肝脏弹性指数、脾脏弹性指数情况。结果 治疗6个月后与对照组患者比较,研究组患者门静脉内径(DPV)、门静脉血流量(QPV) 、脾静脉内径(DSV)、脾静脉血流量(QSV)均更小(均P＜0.05)；治疗后研究组患者Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、层黏蛋白(LN)、Ⅳ型胶原(Ⅳ-C)水平相比对照组患者均更低(均P＜0.05)；治疗后研究组门静脉内径、肝脏弹性指数、脾脏弹性指数相比对照组患者均更小(均P＜0.05)。治疗后研究组患者腹胀、体力减退、黄疸、乏力、肝掌中医症候积分与对照组患者对比均明显更低(均P＜0.05)；结论 和络舒肝片联合替诺福韦用于活动性代偿期乙肝肝硬化患者治疗,能够促进患者脾静脉血流动力学指标改善,提高肝功能改善效果,有助于患者临床症状和体征获得更好缓解。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of Tenofovir combined with Luoshugan tablet and its effect on the improvement of splenic venous blood flow dynamics in patients with cirrhosis.Methods A total of 100 patients with liver cirrhosis who were admitted to the Linping District of the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2019 to October 2022 and met the conditions of this study were selected as the research objects, according to the envelope method, they were randomly divided into the the control groupand the the Study group with 50 cases in each. In the control grouppatients were given Tenofovir 25mg once a time, once a day; In the The Study group patients was treated with Tenofovir plus Heluoshugan 5 tablets/time, 3 times/day. The changes of splenic venous blood flow dynamics index, liver fibrosis index and TCM syndrome score were observed 6 months after treatment.Results After 6 months of treatment, DPV, QPV, DSV and QSV in The Study group patients were smaller than those in the control grouppatients, with statistically significant differences (all P < 0.05). After treatment, the levels of PCⅢ、HA、LNand Ⅳ-C in combination group were lower than those the control grouppatients, and the differences were statistically significant (all P< 0.05). After treatment, the portal vein diameter, liver elasticity index and spleen elasticity index in the Study group patients were smaller than those in the the control group, and the difference was statistically significant (all P < 0.05).After treatment, the scores of abdominal distension, physical loss, jaundice, fatigue and TCM symptoms of liver and paw in the Study group patients were significantly lower than those in the control group, with statistical significance (all P < 0.05). Conclusion Tenofovir combined with Luoshugan tablet for the treatment of patients with active compensatory hepatitis B cirrhosis can promote the improvement of splenic venous blood flow dynamics index, improve the liver function improvement effect, and contribute to better relief of clinical symptoms and signs of patients. |
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